SLOW GASTRIC-EMPTYING IN TYPE-I DIABETES - RELATION TO AUTONOMIC AND PERIPHERAL NEUROPATHY, BLOOD-GLUCOSE, AND GLYCEMIC CONTROL

OBJECTIVE - To investigate whether autonomic neuropathy or hyperglycem ia plays a crucial etiological role in gastric retention of ingesta fr equently found in type I diabetic patients. RESEARCH DESIGN AND METHOD S - We investigated the gastric emptying of a radiolabeled semisolid 1 ,168 kJ meal in 38 female and 45 male patients (age 18-75 years; illne ss duration 3-46 years). None took drugs affecting gastrointestinal mo tility. Fasted patients underwent tests of cardiovascular autonomic an d peripheral nerve function. Blood glucose levels were determined befo re and after the scintigraphic recording of gastric emptying. RESULTS - The percentage of meal remaining in the stomach at the end of the 50 -min recording time was related significantly to the patients' degree of cardiovascular autonomic neuropathy [r (81) = 0.235, P < 0.028] but not to their degree of peripheral neuropathy, preprandial blood gluco se level, HbA(1c) indicatiue of glycemic control, diabetes duration, a nd age. The patients' mean residual percentage of meal was significant ly greater than that of 48 healthy subjects, that is, 71.1 +/- 15.1 vs . 53.5 +/- 13.1% [means +/- SD; t (129) = 6.48, P < 0.0001]. The healt hy individuals' mean residual percentage + 2 SD was exceeded in 22 pat ients. CONCLUSIONS - Slow gastric emptying in patients with type I dia betes seems related to the degree of autonomic neuropathy but not to p eripheral neuropathy, actual blood glucose, and glycemic control.